A 25-Year-Old Man Comes to the Office for Evaluation of Facial

A 25-year-old man comes to the office for evaluation of facial acne.  He has no significant past medical history and does not use tobacco or alcohol.  The patient works as a personal trainer.  His family history is significant for diabetes mellitus in his mother and leukemia in his father.  His blood pressure is 134/82 mm Hg and pulse is 58/min.  On physical examination, there is mild facial acne.  The patient's lungs are clear to auscultation.  The liver span is 8 cm, and the spleen is not palpable.  His testes are soft, and testicular volume is decreased.  Laboratory results are as follows: Which of the following is the most likely explanation for this patient's abnormal laboratory findings?

A) High oxygen affinity hemoglobin
B) Intensive exercise schedule
C) Myeloproliferative disorder
D) Renal artery stenosis
E) Steroid drug abuse
F) Volume depletion due to excessive sweating

Correct Answer:

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